Essential Tremor

Essential tremor (ET) is a debilitating neurological condition that causes shaking in the hands, voice, and head, making it difficult to complete everyday actions such as holding coffee, grooming, and eating.

The condition is often mistaken for Parkinson’s disease, yet according to the National Institute of Neurological Disorders and Stroke, more than 10 million Americans have ET, eight times as many as Parkinson’s.

Our experts at the Center for Neuromodulation at Mount Sinai work closely with neurologists at the Parkinson and Movement Disorders Center to create tailor-made treatment plans, which may include traditional therapies or advanced neurosurgical procedures to help patients return to a normal life.

In addition, the Center provides an information day for ET patients every three month, giving them access to the latest findings and research trials, as well as an opportunity to connect with others with the same condition.

Symptoms of Essential Tremor

ET can affect various extremities of the body, although 95 percent of cases involve the hands, and can cause occasional, temporary, or intermittent symptoms such as:

Rhythmic shaking

Difficulty controlling movements

Mild gait disturbances

Imbalance

The symptoms are often triggered with certain actions, while at rest or while a person is standing. Unfortunately, there is no exact cause for ET, as it can occur in relatively healthy people, both young and old.

There is a genetic component to ET, especially among children. According to the International Essential Tremor Foundation, children who have a parent with ET have a 50 percent change of inheriting the gene, LINGO1, which is associated with the condition.

Deep Brain Stimulation for Essential Tremor

While ET can be mild and non-progressive with some patients, it can be quite severe with others and can worsen over time. Beta-blockers and anti-seizure medications can be used to control symptoms, along with injections into the hands. These medications, unfortunately, are only 50 percent effective and can cause fatigue, sexual dysfunction, and lightheadedness.

Deep brain stimulation (DBS) is an effective treatment for those with ET, especially for those who don’t respond to medication. In some instances, people can show 60 to 80 percent improvement of their symptoms with DBS.

The treatment involves an implant of a tiny electrode in the brain. The electrode is programmed to block signals to the brain that cause the symptoms of ET, therefore providing patients, who have had serious tremors, with long-lasting relief and an improved quality of life.

Qualifications for Deep Brain Stimulation

DBS is an advanced neurosurgical treatment used by the Department of Neurosurgery to treat a variety of movement disorders, including ET. Our neurosurgeons are experts in DBS and will determine if it is the right approach based on a patient’s medical history and severity of the disease. In general, however, the treatment is most successful in patients who have:

Not responded to traditional therapies or medications

Have severe side effects to medication

Have an advanced form of ET that is impairing

For a comprehensive evaluation, call the Center for Neuromodulation at the Department of Neurosurgery at 212-241-0050.